Strokes and Heart Attacks

Here you will find information on maintaining a healthy heart as well as information on diseases which affect the cardiovascular system.The blood vessels – arteries and veins - and the heart are together called the cardiovascular system. Diseases that affect the cardiovascular system include angina, heart attacks and strokes.

Risks factors to heart healthMany people know that certain risk factors influence and increase their chances of getting heart disease. There are some risk factors which we can change or influence, such as smoking, having a high cholesterol level or high blood pressure, being overweight and not being physically active. There are other risk factors which we cannot change. Heart disease is inherited so if there is a history of heart disease in your family, you are more likely to get it. As we get older, we are more at risk of heart disease. Fortunately, at any age and even if you have a history of heart disease in your family, you can reduce your risk of developing the disease. Making some changes now can make a difference for a longer and healthier life.

Maintaining a healthy heartMaking positive changes to your lifestyle can help prevent strokes and heart attacks. There is plenty that you can do yourself to keep your heart healthy.

Quit smoking

Reduce cholesterol by eating more fruit and vegetables and less fat

Try to take about 30 minutes of moderate exercise per day

Eat less salt and reduce your alcohol consumption to help lower blood pressure

AnginaFor many people the first sign of heart disease is angina. Angina happens when the heart muscle does not get enough blood. This happens when the coronary arteries are narrowed because of a build-up of a fatty substance called atheroma. These narrowed arteries are able to bring enough blood to the heart muscle when you are resting but not enough during exercise or stress. When there is not enough blood for the heart, it complains and angina develops.

What are the symptoms of AnginaThe symptoms of angina vary among different people. The discomfort ranges from a tightness in the chest to severe pain. It may develop anywhere from your belly button up to the top of your jaw and down both arms. The discomfort often starts in your chest and spreads to your arms or your hands and even up to your neck or jaw. Sometimes it spreads around your back.

The pain or discomfort is usually continuous. Sharp, stabbing pains are usually not angina. You will usually suffer angina when you are walking or doing something that takes some effort. It lasts longer than a few seconds and eases off when you rest. It may also develop if you become very stressed and eases off as you become more relaxed.

The pain does not usually vary with breathing or with changing your posture as is the case with problems in your lungs or chest wall. Angina usually gets worse if you continue to do exercise. If you have chest pain but can still run around and do physical activity you are unlikely to have angina.

What you can doIt is often very easy to think that you cannot control your health and that only your doctor and some magic drugs are going to keep you well. This is certainly not true. There are many things you can do to reduce the amount of angina attacks you may get. There are also important things to do to improve the state of your arteries. Remember the reason we get angina is because our heart is not getting enough oxygen for its needs. There is a balance between supply and demand, which has been upset. To reduce the demands on your heart you might think you should not move at all. However, there are simple things you can do to reduce the demands on your heart.

Things you can do to reduce angina

Do not exercise for at least 2 hours after a meal

Avoid eating heavy or large meals

Do not carry loads that are too heavy or wear heavy

clothing.

If you are walking outdoors in cold weather always wear a hat and make sure you cover your face with a scarf. The reason for this is that cold air on your face tightens up your arteries.

Use your GTN spray before doing any moderate activities.

It is absolutely essential that you stop smoking. It causes your arteries to tighten up and it reduces the amount of oxygen in your blood.

Regular walking will have a beneficial effect on your weight, blood pressure and cholesterol, and will reduce your angina.

Eat a healthy diet containing fruits and vegetables and avoid high fat foods.

Treatment for anginaMany drugs are used to treat angina. The main drugs used are called nitrates, betablockers and calcium channel blockers.

Nitrates increase the size of the coronary arteries to allow more blood to flow through the coronary arteries to the heart muscle. They also open up other blood vessels (in particular your veins), which bring blood back to your heart. By reducing the amount of blood coming back to your heart it reduces the amount of work your heart has to do. There are short-acting and long-acting types of nitrates. The short-acting glycerine tri-nitrate (GTN) can be given in a small tablet that you put under your tongue. There is also a short acting form of GTN that comes in a spray.

Betablockers are a class of anti-angina drugs that work to make your heart go slower. They also lower your blood pressure and reduce the amount of oxygen your heart needs.

Calcium channel blockers are commonly used to treat angina. They open up arteries and also reduce the work load of your heart. There are many different types of these drugs and they differ in their actions. Some are better at slowing heart rates, and others work better in reducing blood pressure.

There are also other newer drugs used to treat angina which help the cells in the heart muscle work better when the oxygen supply is poor. They are usually added on as part of your treatment if the other drugs mentioned above are not relieving your angina well enough.

Heart attacks A heart attack occurs when the coronary arteries that supply blood to your heart muscle become blocked off. Medically, it is called a myocardial infarction. If the blood supply is cut off for more than a certain period of time, usually about 20 minutes, the muscle cells may die. The coronary arteries which supply blood to the heart muscle may gradually narrow because of a build up of fatty plaque on their inner lining. This build up of plaque is due to a condition called atherosclerosis, which starts in early life. If the plaque breaks, a blood clot occurs at this spot and it may block off the artery completely. A blood clot that develops like this is called a coronary thrombosis and many people refer to a heart attack as simply a coronary.

Symptoms of a heart attackThe most common symptom of a heart attack is chest pain. This is usually a crushing or tight pain, which may move to your jaw or your arms particularly on the left side. You may also feel short of breath, sweaty or sick. Some people may feel light–headed or loose consciousness. You may become very anxious or afraid. However 10-15 per cent of people have a heart attack may not feel anything. This is more common in older people, especially women and those with diabetes. Sometimes these people may just feel weak, tired, or short of breath. Some elderly patients may simply become confused. However, you should remember that you may not experience all of these symptoms, so if in doubt, seek medical help immediately.

Treatment of a heart attackIf you have a heart attack, you will be cared for in the coronary unit of a hospital, where you will be given the treatment you require. Depending on the severity of the attack, this may vary from prescribed drugs to surgery. On recovery, you will be encouraged to enroll in a cardiac rehabilitation programme, which will provide you with help and advice on how to best care for your heart in future. Going through this programmewill help reduce your chances of suffering further angina, heart attacks or strokes.

StrokesA stroke is caused by an interruption of the blood supply to part of the brain. The term ‘stroke’ comes from the fact that it usually happens without any warning, ‘striking’ the person from out of the blue. Although ‘stroke’ is the most correct term for the illness, you may sometimes hear it referred to as a cerebrovascular accident (CVA). A stroke is not a heart attack. As a result of the stroke, the nerve cells in the brain can’t function and the part of the body controlled by those cells also shuts down. The effects of a stroke are worse in the beginning. However, there is usually some amount of recovery in the first six weeks after a stroke.

Symptoms of a strokePeople who experience a stroke may lose use or sensation in the face or limbs, or they may suffer a loss of vision as a result of damage to nerve cells in a part of your brain because the blood supply to the brain has been cut off..

Prevention and treatment of strokesYou can reduce your chances of getting a stroke by making certain changes in your lifestyle, especially not smoking and controlling high blood pressure. If you have high cholesterol, lowering your cholesterol levels may also reduce your risk. Your doctor may tell you to change your lifestyle as well as prescribing medication to reduce your blood pressure. Aspirin or warfarin are often used to prevent clotting and reduce the risk of stroke.